Continuous versus routine EEG in critically ill adults: reimbursement analysis of a randomised trial.

Urbano, Valentina; Novy, Jan; Schindler, Kaspar; Rüegg, Stephan; Alvarez, Vincent; Zubler, Frédéric; Oddo, Mauro; Lee, Jong Woo; Rossetti, Andrea O (2021). Continuous versus routine EEG in critically ill adults: reimbursement analysis of a randomised trial. Swiss medical weekly, 151, w20477. EMH Media 10.4414/smw.2021.20477

[img]
Preview
Text
Urbano__2021__Continuous_versus_routine_EEG.pdf - Published Version
Available under License Creative Commons: Attribution-Noncommercial-No Derivative Works (CC-BY-NC-ND).

Download (591kB) | Preview

BACKGROUND

Continuous EEG (cEEG) is increasingly used in critically ill patients, but it is more resource-intensive than routine EEG (rEEG). In the US, cEEG generates increased hospitalisation charges. This study analysed hospital-related reimbursement for participants in a Swiss multicentre randomised controlled trial that assessed the relationship of cEEG versus repeated rEEG with outcome.

METHODS

We used data of the CERTA study (NCT03129438), including demographics, clinical variables and reimbursement for acute hospitalisations after the Swiss Diagnosis Related Groups billing system. In addition to a comparison between EEG intervention groups, we explored correlations with several clinical variables, using uni- and multivariate analyses.

RESULTS

In total, 366 adults were analysed (184 cEEG, 182 rEEG); 123 (33.6%) were women, mean age was 63.8 years (± 15). Median hospitalisation reimbursement was comparable across EEG groups in univariate analysis: cEEG CHF 89,631 (interquartile range [IQR] 45,635–159,994); rEEG CHF 73,017 (IQR 43,031–158,565); p = 0.432. However, multivariate regression disclosed that increasing reimbursement mostly correlated with longer acute hospitalisation (p <0.001), but also with cEEG (p = 0.019) and lack of seizure / status epilepticus detection (a surrogate of survival, p = 0.036).

CONCLUSION

In a Swiss Diagnosis Related Groups billing system applied to critically ill adults, reimbursement largely depends on duration of acute hospital stay, whereas cEEG and lack of seizure/ status epilepticus detection also contribute to the bill. This differs from the USA, where charges are directly increased by cEEG.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology

UniBE Contributor:

Schindler, Kaspar and Zubler, Frédéric

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1424-3997

Publisher:

EMH Media

Language:

English

Submitter:

Chantal Kottler

Date Deposited:

13 Jul 2021 15:39

Last Modified:

18 Jul 2021 03:07

Publisher DOI:

10.4414/smw.2021.20477

PubMed ID:

33793960

BORIS DOI:

10.48350/157479

URI:

https://boris.unibe.ch/id/eprint/157479

Actions (login required)

Edit item Edit item
Provide Feedback